Question

I see that the new NICE guideline on ME/CFS stresses the importance of checking that people with ME/CFS don’t also have what are called comorbid conditions. Could you explain what a comorbid condition is. And if you have ME/CFS does that mean that you are likely to develop a number of other health conditions as well?

Answer

Co-morbid conditions are separate illnesses that are (or appear to be more) more common, or are linked in some way to a health condition (such as ME/CFS) that you already have.

In the case of ME/CFS there are a number of conditions where we know from both patient evidence and research evidence that you are more likely to develop at some stage in your illness. These include:

• allergies such as hay fever
• chemical sensitivities
• fibromyalgia
• hypermobile joint syndromes
• interstitial cystitis
• irritable bowel syndrome symptoms
• migraine-type headaches
• postural orthostatic tachycardia syndrome (PoTS)

There are also some other conditions where the evidence of a link to ME/CFS is less certain and the situation is therefore not clear. These include: endometriosis, mast-cell activation syndrome and tempero-mandibular joint dysfunction.

Unfortunately, we don’t have yet any robust evidence as to how common each of these conditions are if you have ME/CFS. There are some co-morbid conditions – such as irritable bowel type symptoms – which are fairly common if you have ME/CFS. However, others are less common.

These co-morbid conditions can be present before ME/CFS was diagnosed, occur at around the same time as ME/CFS was diagnosed, or may occur once ME/CFS is established. Whatever the timing, this suggests that there are some similar causative pathways involved in all these conditions.

Having ME/CFS does therefore place people at increased risk of developing one or more of these conditions as time goes on. But some people with ME/CFS won’t develop any of them at all.

As you say, the new NICE guideline recommends that consideration should be given to whether any of these conditions are present when a diagnosis of ME/CFS is being made – as they will need to be properly investigated and managed as well.

More Information

• The MEA has free information leaflets covering fibromyalgia, headaches, interstitial cystitis, irritable bowel syndrome symptoms and PoTS.